Organization
RAISE GEAUGA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY WHOBREY (PROVIDER ENROLLMENT)
(502) 630-7249
Entity
Organization
Contact information
Practice address
5099 CAMELOT DR, FAIRFIELD, OH 45014-7423
(513) 858-4550
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 394-2100
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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